Common Contracts
4 similar Agreement for Service / Informed Consent and Notice of Privacy Practices contracts
AGREEMENT FOR SERVICE / INFORMED CONSENT AND NOTICE OF PRIVACY PRACTICESAgreement for Service / Informed Consent and Notice of Privacy Practices • February 23rd, 2022
This Agreement is intended to provide the undersigned (herein “Patient” or “you”) with important information regarding the practices, polices and procedures of Jeff Strnad, LMFT (herein “Therapist” or “I”), and to clarify the nature and terms of the professional therapeutic relationship between Therapist and Patient. Any questions or concerns regarding the contents of this Agreement should be discussed with Therapist prior to signing it.
AGREEMENT FOR SERVICE / INFORMED CONSENT AND NOTICE OF PRIVACY PRACTICESAgreement for Service / Informed Consent and Notice of Privacy Practices • March 10th, 2021
This Agreement is intended to provide (herein “Patient” or “you”) with important information regarding the practices, polices and procedures of Jeff Strnad, LMFT (herein “Therapist” or “I”), and to clarify the nature and terms of the professional therapeutic relationship between Therapist and Patient. Any questions or concerns regarding the contents of this Agreement should be discussed with Therapist prior to signing it.
AGREEMENT FOR SERVICE / INFORMED CONSENT AND NOTICE OF PRIVACY PRACTICESAgreement for Service / Informed Consent and Notice of Privacy Practices • October 29th, 2020
This Agreement is intended to provide (herein “Patient” or “you”) with important information regarding the practices, polices and procedures of Jeff Strnad, LMFT (herein “Therapist” or “I”), and to clarify the nature and terms of the professional therapeutic relationship between Therapist and Patient. Any questions or concerns regarding the contents of this Agreement should be discussed with Therapist prior to signing it.
AGREEMENT FOR SERVICE / INFORMED CONSENT AND NOTICE OF PRIVACY PRACTICESAgreement for Service / Informed Consent and Notice of Privacy Practices • March 9th, 2017
This Agreement is intended to provide (herein “Patient” or “you”) with important information regarding the practices, polices and procedures of Jeff Strnad, LMFT (herein “Therapist” or “I”), and to clarify the nature and terms of the professional therapeutic relationship between Therapist and Patient. Any questions or concerns regarding the contents of this Agreement should be discussed with Therapist prior to signing it.
